1. Technical Field
The present invention relates to an apparatus and method for closing a skin wound and more specifically to the art of using tissue glue in combination with tissue approximation forceps to glue wound edges together.
2. Background Art
In recent years, tissue adhesives such as the cyanoacrylates have become widely used for closing skin wounds, both those caused by trauma and those made as surgical incisions. In many cases, the use of tissue adhesives instead of skin sutures or staples allows wounds to be closed without the need for injecting local anesthetic into a wound, thereby expediting the procedure and sparing the patient the pain of an injection.
When a wound is closed using sutures, the process of placing the sutures and tying the associated knots brings the wound edges into proper alignment at the same time that it closes the wound and secures that alignment. Thus it is not necessary to hold the wound edges together during suturing.
When tissue adhesives are used appropriately, they yield cosmetic results typically better than the results achieved using sutures. The chief difficulty with using adhesives to close a wound is that the edges of the wound must be brought into alignment and held there as the liquid adhesive is applied. Unlike sutures, the wound edges must be held and kept in alignment while the adhesive cures. To assist in the process of keeping the wound edges aligned while the adhesive cures, there have been attempts to use prior art tissue forceps. However prior art forceps are not well suited to this task.
Prior art tissue forceps come in a variety of types, each with various tissue mating surfaces adapted for the purpose of grasping the tissue adjacent the edges of a wound in a secure manner. These mating surfaces give only a limited degree of control over the wound edges. Prior art forceps indent the skin and evert the wound edges during closure. This is most desirable for suturing a wound because the edges eventually flatten and give a cosmetically acceptable result. However it is not desireable for wound closure when using a tissue adhesive material in place of sutures.
Prior art forceps also require that one of the treating surgeon's hands be used to secure the forceps in position during the wound closure procedure due to the fact that the forceps will not remain on the skin if one hand does not remain on the forceps. Such limitations in the prior art therefore did not allow the use of two hands to stitch or apply the tissue glue. It is more desirable if the surgeon has his second hand available. The surgeon could then use that second hand to steady the patient rather than keeping it on the forceps in order to keep the wound edges together.
Also In the prior art, if the patient moves then the forceps will move and the wound edges will not maintain registration. When the forceps slip out of position, the wound may open and allow tissue glue to enter the wound. If such forceps were capable of remaining attached to the skin in the closed position, then they would also be free to move with the patient's movement without a loss of wound edge closure.
To solve the aforementioned problems associated with wound closure, the present invention is a unique system for simple and reliable closing of the edges of a wound allowing for optimal application of tissue glue.
The new and improved tissue forceps, according to the present invention, have independent and detachable tissue mating surfaces which adhesively engage the skin adjacent to a wound in a manner which approximates the wound edges. The forceps may also include a locking mechanism which, in many cases, allows the operator to let go of the forceps once the wound edges have been positioned, thereby freeing up one hand.